Healthcare Provider Details

I. General information

NPI: 1093627325
Provider Name (Legal Business Name): THRIVE THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1061 BRIDGE ST
PHILADELPHIA PA
19124-1824
US

IV. Provider business mailing address

127 S WELLS AVE
GLENOLDEN PA
19036-1734
US

V. Phone/Fax

Practice location:
  • Phone: 267-225-7180
  • Fax:
Mailing address:
  • Phone: 267-579-7850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ISAAC AKWASI AGYAPONG
Title or Position: LICENSE BEHAVIOR SPECIALIST
Credential: MS
Phone: 267-579-7850